Healthcare Provider Details

I. General information

NPI: 1841275237
Provider Name (Legal Business Name): JONATHAN G. FLORES 1 PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2065 AIRPORT BLVD
PENSACOLA FL
32504-5931
US

IV. Provider business mailing address

9040 ASHVILLE DR
PENSACOLA FL
32514-5691
US

V. Phone/Fax

Practice location:
  • Phone: 850-477-6966
  • Fax: 850-477-0267
Mailing address:
  • Phone: 850-477-6966
  • Fax: 850-477-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20549
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: